Distal renal tubular acidosis can present as hypokalaemic periodic paralysis in young males and responds to conservative management.
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May prompt distal RTA evaluation in hypokalaemic periodic paralysis; leaves generalizability of conservative response open.
A 21-year-old normotensive male presented with acute onset flaccid paralysis with the history of a similar episode a few months back. Clinical and laboratory evaluation revealed lower motor neuron type of flaccid quadriparesis with hypokalaemia, normal anion gap metabolic acidosis, bicarbonaturia, and transtubular potassium concentration gradient (TTKG) more than 7. Subsequently urine acidification test (by NH4CI challenge test) was done and diagnosis of distal renal tubular acidosis was established. The patient responded to conservative management (Sohl's solution).
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Talreja et al. (2016) studied this question.
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